What Is Magnetic Resonance Enterography?

Magnetic resonance enterography, or MR enterography, is a painless imaging test used to diagnose problems specifically in your small intestine. This test is a specialized type of magnetic resonance imaging (MRI), a form of imaging that provides detailed views of your organs through the use of a strong magnetic field.

This article discusses what MR enterography is and what it is used for. It also explains the procedure, the potential risks, as well as the process of getting your results.

Purpose of Test

With MR enterography, your healthcare provider can get very detailed images of your small intestine. This can help them find problems, diagnose your condition, and monitor your treatment.

The procedure is done in an MRI machine, which uses powerful magnets to produce a strong magnetic field.

MR enterography is performed with a contrast material, which is a liquid that helps to improve the quality of images. Contrast material is given by mouth and/or delivered into the vein.

This test does not involve radiation, a form of energy that can cause damage to the body. Because of this, the procedure may be used to evaluate individuals who need frequent imaging done.

Using MR enterography can help reduce the exposure to radiation that is emitted in other medical imaging tests like X-rays and computed tomography (CT) scans.

Diagnosis

Healthcare providers use MR enterography to diagnose a number of medical conditions that affect the small intestine.

MR enterography can identify:

• Inflammation, which can lead to redness, swelling, and pain
• Internal bleeding
• Abscesses, or pus-filled bumps
• Tears in the intestine
• Bowel obstructions, or blockages in the intestine
• Small bowel polyps, or clumps of noncancerous abnormal tissue growth
• Tumors, or abnormal tissue growth that may be cancerous

Monitoring

MR enterography may also be used to track how well certain treatments are working and to detect any complications.

Differences and Limitations

Unlike a CT scan or X-ray, MR enterography:

• Does not use X-rays, a type of radiation, to produce images
• Uses a contrast material that is less likely to cause an allergic reaction compared to iodine-based ones that are used with other tests
• Shows abnormal and normal tissue differences more clearly
• Takes much longer to perform (30 to 45 minutes compared to just a few minutes)

One of the limitations of MR enterography is that movement may impact the image quality. To get the best images, you must remain still and follow breath-holding instructions during the procedure.

If you feel anxious beforehand, you may find it difficult to keep still while the procedure is happening. Your healthcare provider may recommend taking a sedative, a medication that helps you feel calm and relaxed, before the MR enterography.

Another limitation of MR enterography is that MRI machines have different weight and size capacities. This means that some individuals won't be able to use certain MRI machines.

Risks and Contraindications

MR enterography uses a strong magnetic field, so it's crucial to let your healthcare team know if you have any devices, implants, or metal in your body, or if you have worked with metal in the past. The magnetic field may cause some medical devices to malfunction.

Individuals with certain implants cannot have this procedure, so be sure to speak with your healthcare provider about the safety of this test for you.

Prior to having MR enterography, there are a few things to keep in mind:

• It’s important to tell your healthcare provider if you have a history of kidney disease, or kidney damage, as well as other health conditions.
• Let your healthcare provider know if you have had surgery or medical treatment recently. 
• There is a small risk of an allergic reaction when the contrast material is given. Tell your healthcare team right away if you develop symptoms.
• Be sure to tell your healthcare team if you have any metal objects in your body.
• It’s recommended that pregnant individuals avoid having any type of MRI exam as a precaution, particularly during the first trimester.
• Those with poor kidney function face the risk of nephrogenic systemic fibrosis, a rare condition that can impact the skin, movement, and organ functioning. This complication is caused by the contrast material.

Possible Disqualifications

Certain individuals should not undergo MR enterography. These include individuals with:

• A cochlear implant, or a small device that helps with hearing
• Certain types of clips that help stop the flow of blood into a brain aneurysm, or bulge in a blood vessel
• Certain types of metal coils placed within blood vessels, which help the blood clot or clump together
• Nearly all cardiac defibrillators and pacemakers, or devices that help regulate the heartbeat

Before the Test

Before the test, be sure your healthcare provider knows your medical history, including current and past conditions, allergies, as well as your history of working with metal. They should be aware of recent surgeries, as well as any medical devices, and implants. You should also let them know if you are or could be pregnant.

If you have claustrophobia, or fear of confined spaces, or anxiety, your healthcare provider may give you a prescription for a sedative prior to your MR enterography.

Before your procedure, you may want to ask your healthcare provider:

• Whether you need to stop taking any of your regular medicines or supplements before the procedure
• When to stop eating and drinking before the exam, or if you should avoid certain foods 
• What results to expect and what they mean
• Any alternative tests or procedures you might want to consider

In general, it’s also essential to understand why you are undergoing MR enterography. If you have any questions or concerns about why you’re receiving this test, don’t hesitate to ask your healthcare provider.

Timing

MR enterography takes about 45 minutes. However, you may need to arrive two and a half hours prior to the exam in order to drink an oral contrast material. The oral contrast may be provided at 30-minute intervals.

During your check-in process, you may be asked to fill out a safety form.

Location

MR enterography is often performed at hospitals or at imaging centers. Your healthcare provider will inform you where your exam will take place.

Typically, the MRI unit is a large, cylinder-shaped tube surrounded by a circular magnet. During the exam, you’ll lie on a movable examination table that slides into the center of the magnet.

What to Wear

When undergoing MR enterography, wear comfortable clothing and leave your jewelry at home. Once you arrive at your appointment, you’ll be asked to change into a hospital gown and lock up your belongings.

Cost and Health Insurance

Your MR enterography may be covered by your health insurance. Depending on your plan, you may have to pay a co-pay and/or coinsurance. Some insurance plans may require pre-authorization for MR enterography.

Food and Drink 

Instructions on eating and drinking prior to undergoing MR enterography tend to vary between facilities, so be sure to carefully read the instructions given to you. Unless you’re told otherwise, continue taking your regular medications as usual.

What to Bring

If you have a medical device or implant, bring along any information you have about it to show your healthcare provider prior to undergoing MR enterography.

You should also bring your ID and insurance card to the exam.

Other Considerations

If you’re planning on receiving a sedative before your MR enterography, make arrangements for a ride home from the exam.

Since the MRI machine may produce loud noises, you may be given earplugs or headphones to wear during the exam. This will block the noise of the machine, while still allowing you to hear the technologist, or the person operating the MRI machine.

During the Test

Pre-Test

When you arrive at the facility, you'll be asked to change into a gown. Before your MR enterography, your healthcare team may review your health and medication history and check your heart rate, temperature, and blood pressure.

A needle will be inserted in a vein in your hand or arm to give you fluids. You may be asked to drink an oral contrast drink in timed intervals. A contrast agent may also be given via the inserted needle. You may experience a cold sensation when the contrast enters your bloodstream. You might also get a metallic taste in your mouth.

You’ll lie flat on your back on a table that slides in and out of the scanner. In some cases, straps may be used to help you stay in the correct position. The technologist may put a pillow under your head and a cushion under your knees.

Throughout the Test

During the exam, you’ll be placed into the MRI unit and the radiologist, or doctor that specializes in using imaging techniques to treat conditions, as well as the technologist will carry out the procedure. During this time, they will be working at a computer outside of the room. The scanner is well-lit and kept cool.

During the exam, two sets of pictures may be taken. These images show different parts of your small intestine and the surrounding tissues. After the first set of pictures, your radiologist will look at the images to ensure that you have enough of the contrast in your intestines. In some cases, you may have to walk around to help move the contrast through your intestines.

You may feel some warmth in the area of your body that's being scanned. This feeling is normal, but let your technologist know if it bothers you.

During the exam, your technologist may ask you to hold your breath at certain points. This helps improve the quality of the images obtained.

Although you’ll be alone in the room during the MR enterography, you can talk to the technologist at any time.

Post-Test

After the test is complete, you may need to wait a few minutes while your healthcare team determines whether any additional images are needed.

Once all images are done, the exam table will slide out from the MRI tube. Any needles will be taken out at this time.

If you had anesthesia, or a medication that decreases pain and awareness, you will be taken to a recovery room after the exam. Otherwise, you can go home right away.

After the Test

It’s normal for people to feel slightly full or a bit nauseated for several hours after undergoing MR enterography. Some people may experience some cramping or diarrhea. If these symptoms don’t subside by the next day or are severe, make sure to consult your healthcare provider.

In addition, there’s a very small risk of skin irritation at the site where the needle was inserted.

There are no post-exam dietary restrictions associated with MR enterography. You may continue with your usual eating and drinking routine after the procedure.

It should be noted that manufacturers of intravenous contrast suggest that individuals avoid breastfeeding their babies for up to 48 hours after receiving contrast medium. However, the American College of Radiology state that it is safe to continue breastfeeding after receiving contrast directly into the vein.

Interpreting Results

After your MR enterography, a radiologist will analyze the images and send a report to your primary care provider or referring practitioner. Your healthcare provider will then share these results with you.

While results generally take several days to come back, the wait time varies depending on the facility.

Follow-Up

If your MR enterography results aren’t normal, you may need additional imaging. This may involve having another MRI, a CT scan, an X-ray, or other types of medical tests. Talk to your healthcare provider about how to proceed in the event of abnormal results.

Summary

MR enterography is a painless imaging test that is used to get very detailed images of your small intestine. This helps your healthcare provider make a diagnosis, as well as monitor your treatment.

Some individuals should not have this test done, so be sure to tell your healthcare provider your detailed medical history to ensure that this test is safe for you.

Before, during, and after the test, your healthcare provider will give you specific instructions to follow. This ensures that they can get the best images possible, while also helping you feel comfortable throughout this process.

A Word From Verywell

Because waiting for test results may cause anxiety, it’s important to take steps to ease your worries. Along with spending time with your loved ones, focus on enjoyable activities that keep your mind occupied.

If you have any questions during the waiting period, don’t hesitate to reach out to your healthcare provider.